The establishment of the Federal State Budgetary Scientific Institution «Far Eastern Scientific Center for Physiology and Pathology of Respiration» is examined within the historical progression of academic science in the Russian Far East and the Russian Academy of Sciences' contribution to this development, commemorating its 300th anniversary in Russia. The outcomes of medical science and healthcare contributions to pulmonology advancement in the Far Eastern region are evaluated.

Aim. The study of clinical and functional characteristics, features of pharmacotherapy and the level of adherence in severe and difficult-to-treat bronchial asthma in real clinical practice to optimize pathogenetic therapy measures.

Materials and methods. 143 patients diagnosed with severe bronchial asthma were examined. Patients were divided into 2 groups: difficult-to-treat bronchial asthma and severe bronchial asthma. Examination methods included: anamnestic method, physical examination, filling out the ACQ-5 questionnaire, AST, the Morisky-Green questionnaire, instrumental (spirography with bronchodilator), laboratory methods.

Results. Most of the studied patients were patients with difficultto-treat bronchial asthma (55%), while patients with severe bronchial asthma accounted for 45% of the total number of patients. We noted that patients of the 1st group were more often hospitalized due to an exacerbation of the disease. There were no significant differences in clinical and functional parameters and in the structure of comorbidity. All patients received the amount of basic therapy corresponding to stages 4 and 5 in accordance with GINA 2022. According to the results of the Morisky-Green questionnaire, lack of adherence was recorded in 79% of cases. Incorrect inhalation technique among patients of the 1st group was recorded in 32% of cases, while an uncontrolled course of concomitant pathology was detected in a third (33%) of cases. In group 2, 94% of patients had at least one marker of T2 inflammation.

Conclusions. Among patients with difficult-to-treat asthma, truly severe bronchial asthma was confirmed in 45% of cases, bronchial asthma difficult-to-treat - in 55% of cases. Lack of adherence (79% of cases), uncontrolled course of comorbidity (33%), and incorrect inhalation technique (32% of cases) are the main factors hindering the achievement of control in the difficult-to-treat asthma group. For patients with difficult-to-treat asthma, it is necessary to take measures aimed primarily at improving adherence to treatment.

This article presents the findings of an open, comparative, prospective study aimed to investigate the state of vascular endothelial function in patients with chronic obstructive pulmonary disease (COPD) who have recovered from COVID-19, and to assess the potential for long-term prediction of preclinical atherosclerosis development.

Materials and methods. A total of 133 COPD patients were examined under outpatient conditions: the main group (n=90), with a history of COVID-19, and a comparison group (n=43). Participants were examined twice: V1 - initial examination from 3 weeks to three months post-infection, V2 - a follow-up examination 12 months after the first visit. Based on the CAVI index values at point V2, the main group was divided into 2 subgroups. The state of vascular endothelial function was assessed using volume sphygmomanometry and by determining the concentration of biochemical markers in the blood.

Results. In the main group at point V2, the studied parameters of arterial stiffness were significantly higher compared to the comparison group (aortic pulse wave velocity, cardio-ankle vascular index (CAVI) on the right and left, augmentation indices on the brachial and carotid arteries). At point V1, in the 1st subgroup (R-CAVI≥8.5 units), the concentration of biomarkers such as endothelin-1, total homocysteine, monocyte chemoattractant protein, vascular endothelial growth factor, C-reactive protein, interleukin-6,10 was significantly higher than in the 2nd subgroup (R-CAVI<8.5 units). Conclusion. Taking into account the results obtained, a mathematical model for predicting preclinical atherosclerosis in COPD patients 12 months after COVID-19 was developed, which can be applied by clinicians in the long-term assessment of cardiovascular risk. Key words: chronic obstructive pulmonary disease, COVID-19, sphygmomanometry, predictors, prognosis, CAVI index> ˂ 8.5 units).

Conclusion. Taking into account the results obtained, a mathematical model for predicting preclinical atherosclerosis in COPD patients 12 months after COVID-19 was developed, which can be applied by clinicians in the long-term assessment of cardiovascular risk.

Aim. The study aims to evaluate the effectiveness of a comprehensive rehabilitation program for patients experiencing reduced respiratory muscle strength following coronavirus pneumonia.

Materials and methods. This prospective, ran-domized study enrolled 55 individuals (average age 66.1±6.4 years; 21.8% males and 78.2% females) who had recovered from COVID-19. The rehabilitation regimen included 10 sessions of respiratory exercises, 10 chest massage treatments, and 3 sessions of osteopathic adjustment. Assessments of respiratory function and respiratory muscle strength were conducted both before the initiation of rehabilitation and upon its completion.

Results. Initial complaints included rapid fatigue, dyspnea under physical strain, vertigo, headaches, chest pain during respiration, and disrupted sleep patterns. Participants were categorized into two groups: males and females. Both groups demonstrated a decrease in expiratory muscle strength by a factor of 1.2 and inspiratory muscle strength by 1.6, compared to normative values. Spirometry indicated impaired lung function across all participants. Post-rehabilitation, a marked improvement in overall health and a reduction in complaint severity were observed. Rehabilitation routing scales showed a decrease in condition severity from 2-3 points to 1-2 points, alongside a statistically significant increase in respiratory muscle strength, enhanced oxygen saturation, and restored lung function.

Conclusion. Our proposed comprehensive rehabilitation program, incorporating osteopathic manipulation, respiratory exercises, and massage, successfully shifts the pathological breathing pattern to a physiological one, strengthens respiratory muscles, and reinstates lung function. This leads to improved exercise, reduced anxiety and depression levels, and enhanced quality of life for post-COVID-19 pneumonia patients.

Introduction. The role of phagocytes, regulated by interleukin 8 (IL-8), in the formation of the bronchial response to environmental stimuli in patients with asthma is not well understood.

Aim. To study the functional activity of IL-8 and the pool of phagocytic cells in the inflammatory pattern of the bronchi in patients with non-allergic asthma during inhalation exposure to cold air.

Materials and methods. In 129 patients with mild to moderate asthma, the content of IL-8 and the cellular composition of sputum before and after the bronchoprovocation test with isocapnic hyperventilation with cold air (-20°C) (IHCA) were analyzed.

Results. Based on the results of the IHCA by the assessment of changes in FEV1 (Δ,%), 54 patients (1st group) were verified with cold airway hyperresponsiveness (CAHR), the comparison group consisted of asthma patients (2nd group, n=75) who did not respond to the trigger (ΔFEV1 = -18.9±1.2 and -3.3±0.4%; p<0.0001, respectively). The content of neutrophils in sputum before provocation was 41.1±2.2% and 34.5±2.2% (p><0.05), macrophages – 36.2±2.7% and 43.1±2.5% (p> ˂ 0.0001, respectively). The content of neutrophils in sputum before provocation was 41.1±2.2% and 34.5±2.2% (p ˂ 0.05), macrophages – 36.2±2.7% and 43.1±2.5% (p>0.05), respectively. In response to the IHCA in the 1st group, the number of neutrophils increased to 48.2±2.0% (p ˂ 0.05), macrophages decreased to 28.7±2.1% (p ˂ 0.01), and the level of IL-8 increased from 12838±2328 to 17412±2980 pg/mL (p ˂ 0.05). In the 2nd group, the concentration of IL-8 before the IHCA was 14639±2691 pg/mL, after the test 10545±1746 pg/mL (p>0.05); the number of neutrophils after the test 40.0±2.3% (p>0.05); macrophages – 35.8±2.0% (p ˂ 0.01).

Conclusion. In asthma patients with CAHR, the inflammatory pattern of the bronchi in response to the cold trigger shows enhanced IL-8 activity and more pronounced changes in the content of phagocytes, mobilized with the involvement of this cytokine.

Introduction. Bronchial asthma is characterized by heterogeneity, multiple phenotypes, and varying clinical manifestations. Cytokines play a crucial role in the inflammatory response in asthma. The quantity, as well as the ratio of certain cytokines, determines the mechanism and type of inflammatory response in asthma, upon which the effectiveness of treatment of this disease depends. That is why the development of new methods of treating patients with asthma, aimed at correcting cytokine imbalance, is required. One of the promising substances is N-eicosapentaenoyl-ethanolamine (NAE-EPA), which exhibits anti-inflammatory properties by affecting cytokines, but remains poorly studied.

Aim. To study the dose-dependent effect of N-eicosapentaenoyl-ethanolamine on the production of cytokines by peripheral blood cells, in vitro, in subjects with asthma.

Materials and methods. The object of the study was whole blood, diluted 1:5 with culture medium of 15 patients with mild to moderate controlled asthma and 16 healthy subjects. The in vitro experiment was carried out in lipopolysaccharide-stimulated (LPS) blood samples (incubation with LPS at 37°C for 30 minutes). Then, the experimental substance N-acylethanolamine eicosapentaenoic acid (NAE EPA) was added in concentrations of 1.0; 5.0, and 10.0 µM and incubated at 37°C for 6 hours with gentle mixing. Cytokine levels (IL-2, IL-4, IL-6, IL-10, IL17A, TNF-α, and INF-γ) were studied by enzyme-linked immunoassay.

Results. Analysis of the level of cytokines in patients with asthma showed that an increase in the plasma levels of IL-2, TNF-α, IL-6, and IL-17A is accompanied by a decrease in the level of regulatory IL-10. When NAE EPA was added at a dosage of 1 µM, no statistically significant changes were detected. Exposure to the experimental substance at a dose of 5 µM contributed to a decrease in IL-6 in the blood cells of patients by 19% (p ˂ 0.05). Exposure to NAE EPA at 10 µM produced the greatest number of statistically significant changes in cytokine levels. There was a decrease in IL-17A by 15% (p ˂ 0.05), IL-2 by 14% (p ˂ 0.05), IL-6 by 50% (p ˂ 0.01), and TNF-α by 10% (p ˂ 0.05) relative to values before exposure.

Conclusion. N-eicosapentaenoyl ethanolamine shows potential as a regulator of pro- and anti-inflammatory cytokine synthesis in bronchial asthma with a predominant Th-17 type of immune response. The results obtained may contribute to the development of new treatment strategies for patients with asthma.

Introduction. According to the World Health Organization ambient air pollution causes enormous harm to public health around the world. Atmospheric solid suspended particles are a heterogeneous mixture of substances with various dimensional, qualitative and quantitative parameters. They are a key indicator of air pollution, contributing to the bronchopulmonary pathology formation. At the moment, there is no general recommended ranking of the solid suspended particles amount in the atmospheric air.

Aim. Determination of the SSP fractional content in the air ground layer in high and relatively low technogenic load areas of Vladivostok.

Materials and methods. Atmospheric air samples were taken «in the breathing zone» using an electric aspirator. In the granulometric analysis of SSP, the particle size distribution, expressed as a percentage, and the mass concentration of fractions (μg/m3 ) were determined. The ranges of dimensions have been identified, taking into account the solid suspended particles possible origin and the expected pathophysiological features of their effect on the organism.

Results. An area with a high technogenic load is characterized by the prevalence of particles with a diameter of up to 10 microns, which have the most pathogenic effect on the organism. In an area with a relatively low technogenic load, particles of larger fractions (10-25, 1000-2000 microns) predominate.

Conclusion. Studying the solid suspended particles parameters in specific areas and establishing their influence cellular mechanisms can help in the development of new strategies for the prevention of environmentally-related pathologies.

Introduction. The pathogenetic role of biochemical changes in the development of diabetic retinopathy (DR) is undoubted and determines the importance of studies that reveal metabolic disorders of both individual molecules and show the relationships between them. Because of some commonalities between tissue respiration, monosaccharide and tryptophan exchange, and activation of lipid peroxidation (LP), there is an interest in studying the relationship between metabolites of these pathways in retinopathy.

Aim. The aim is to study the content of metabolites of the kynurenic pathway and intermediate product of lipid peroxidation in blood, and to reveal the correlation between them and glycated hemoglobin’s (HbA1c) level in retinopathy with type 2 diabetes.

Materials and methods. The 1st group (control group) included 21 healthy people; the 2nd group included 21 people with «prediabetes», the 3rd group - 21 patients with type 2 diabetes, the 4th group - 63 people with type 2 diabetes and diabetic retinopathy (DR) of varying severity levels. The content of kynurenines in the blood plasma (kynurenine (KYN), 3-hydroxykynurenine (3-HKYN), kynurenic acid (KYNA)) of all participants, as well as the concentration of malondialdehyde (MDA) was determined by high-performance liquid chromatography using a Shimadzu LC-20 chromatograph (Japan). The level of glycated hemoglobin (HbA1c) was determined using Beckman Coulter AU 480 (USA) biochemical analyzer. The results were calculated using Jamovi program version 2.3.

Results. In the group of people with «prediabetes», the values of all studied parameters in the blood plasma were increased in comparison with the control group. In the group of patients with type 2 diabetes, the levels of KYN, 3- НKYN and MDA significantly exceeded those in the group of people with «prediabetes». In the group of people with DR, all indicators remained high, the values of 3-НKYN and KYNA showed a statistical difference compared to the group of patients with diabetes. When conducting a correlation analysis, corellations were identified between the level of HbA1c on the one hand and the values of KYN (r=0.77; p ˂ 0.001), concentrations of 3-НKYN (r=0.80; p ˂ 0.001), KYNA (r= 0.72; p ˂ 0.001) and MDA (r=0.84; p ˂ 0.001) – on the other. There was a correlation between HbA1c level and fundus scale (r=0.82; p ˂ 0.001) and between concentrations (of 3-HKYN) and MDA (r=0.50; p=0.002).

Conclusion. An increased level of glycosylated hemoglobin and lipid peroxidation products in the blood during retinopathy against the background of type 2 diabetes, an increase in the concentrations of KYN, 3-HKYN, KYNA, and the presence of correlations between these indicators serve as the basis for proving the relationship of uncontrolled hyperglycemia with changes in cellular respiration and the development of oxidative stress. Hypoxic effects and the accumulation of intermediate metabolic products of the kynurenine pathway contribute to progressive neurovascular damage to the retina, activation of lipid peroxidation processes and inflammation.

Aim. The aim of the study was to investigate the functional state of the «lipid peroxidation - antioxidant defense» system in the peripheral blood of parturients with mild and severe COVID-19.

Materials and methods. This casecontrol study examined 95 parturients with confirmed COVID-19 diagnosis in the third trimester, divided into two groups based on the severity of the disease. Group 1a included parturients with severe COVID-19 (community-acquired pneumonia, n=48), while group 1b consisted of patients with mild COVID-19 (acute respiratory viral infection, n=47). The control group was composed of 45 parturients without a prior or current diagnosis of COVID-19. The average age of women in the study groups was 23.9±0.50 years, and 24.4±0.60 years in the control group (p>0.05). Peripheral venous blood served as the material for the study. Spectrophotometric methods were used to examine the concentrations of primary (diene conjugates - DC) and final (active thiobarbituric acid products - TBARS) products of lipoperoxidation. The content of 8-isoprostane, total antioxidant capacity of plasma components, and phospholipase A2 were investigated using enzymelinked immunosorbent assay (ELISA).

Results. Study showed that parturients with severe COVID-19 had increased levels of phospholipase A2 by 2.1 times (p<0.001), oxidative stress markers: diene conjugate concentrations by 1.94 times (p><0.001), TBARS by 2.2 times (p><0.001), and 8-isoprostane by more than 2 times (p><0.001), along with a simultaneous decrease in the total antioxidant capacity of blood plasma components by 1.7 times (p><0.001) compared to the control group. In the group of parturients with mild COVID-19, the studied indicators changed less significantly. Conclusion. The study established the pathogenetic role of SARS-CoV-2 in disrupting the functional system of «lipid peroxidation - antioxidant defense» and the development of oxidative stress in parturients who had COVID-19 in the third trimester. A dependency of oxidative stress marker concentrations in peripheral blood on the severity of COVID-19 was identified. It was shown that COVID-19 in the third trimester of pregnancy is associated with high levels of phospholipase A2, an imbalance in the prooxidant-antioxidant system, characterized by a reduction in the level of total antioxidant capacity and an increase in oxidative modification products of biomolecules, expressed by the growth of DC, TBARS, and 8-isoprostane levels, leading to oxidative stress correlated with the severity of lung damage. Key words: COVID-19, parturients, lipid peroxidation, antioxidant defense, oxidative stress> ˂ 0.001), oxidative stress markers: diene conjugate concentrations by 1.94 times (p ˂ 0.001), TBARS by 2.2 times (p ˂ 0.001), and 8-isoprostane by more than 2 times (p ˂ 0.001), along with a simultaneous decrease in the total antioxidant capacity of blood plasma components by 1.7 times (p ˂ 0.001) compared to the control group. In the group of parturients with mild COVID-19, the studied indicators changed less significantly.

Conclusion. The study established the pathogenetic role of SARS-CoV-2 in disrupting the functional system of «lipid peroxidation - antioxidant defense» and the development of oxidative stress in parturients who had COVID-19 in the third trimester. A dependency of oxidative stress marker concentrations in peripheral blood on the severity of COVID-19 was identified. It was shown that COVID-19 in the third trimester of pregnancy is associated with high levels of phospholipase A2, an imbalance in the prooxidant-antioxidant system, characterized by a reduction in the level of total antioxidant capacity and an increase in oxidative modification products of biomolecules, expressed by the growth of DC, TBARS, and 8-isoprostane levels, leading to oxidative stress correlated with the severity of lung damage.

Introduction. COVID-19 in pregnant women adversely affects the course of the disease, pregnancy outcomes, and morbidity in newborns. However, studies on the impact of the gestational age at which SARS-CoV-2 infection occurs on the risk of neonatal morbidity are lacking.

Aim. To assess the risks of adverse pregnancy outcomes and neonatal morbidity in newborns depending on the gestational age at which women were infected with SARS-CoV-2.

Materials and methods. The study included 215 women infected with SARS-CoV-2 in the first, second, and third trimesters of pregnancy and 50 uninfected pregnant women. Newborns formed corresponding groups. Data for analysis (general clinical, anamnestic, childbirth outcomes, and newborn condition) were obtained from the records of pregnant, laboring, and postpartum women.

Results. In 4.7% of women infected in the first trimester, pregnancy was accompanied by spontaneous miscarriage and in 1.9% by ectopic pregnancy development. In 1.9% of women infected in the second trimester, antenatal fetal demise in a full-term pregnancy was detected. Patients infected with SARS-CoV-2 more often underwent cesarean section (31.7%). The median weight and height of newborns from mothers infected with SARS-CoV-2 were lower than in the control group. The Apgar score at the first minute showed no differences, but at the fifth minute, it was lower than in the control group. Newborns from mothers infected with SARS-CoV-2 were more frequently diagnosed with cerebral ischemia (26.3%), motor disorder syndrome (20.7%), and persistent fetal circulation (27.8%). Only in newborns from mothers with SARS-CoV-2 were hypertensive syndrome (13.1%), posthypoxic cardiomyopathy (13.1%), and intraventricular hemorrhages (10.1%) detected. The Apgar score at the first minute in newborns from mothers infected with SARS-CoV-2 in the third trimester of pregnancy was higher compared to infections in the second trimester. Neonatal morbidity in this cohort of newborns was characterized by a high frequency of cerebral ischemia, motor disorder syndrome, hypertensive syndrome, and persistent fetal circulation. Infection in the third trimester increased the risk of neonatal morbidity: cerebral ischemia by 5.6 times, motor disorder syndrome by 13.78 times, hypertensive syndrome by 8.61 times, and persistent fetal circulation by 2.76 times.

Conclusion. COVID-19 during pregnancy increases the risks of adverse outcomes and the development of neonatal pathology in newborns. The frequency of their development is associated with the gestational age at which women were infected. Infection of women with SARS-CoV-2 in the first and second trimesters of pregnancy increases the risk of spontaneous miscarriage and antenatal fetal death, in the third trimester – the development of intraventricular hemorrhages and posthypoxic cardiomyopathy in newborns.

Introduction. The relevance of the study is due to the high frequency of complications after the use of drugs for treating malignant tumors, which is associated with the cytotoxic effect of chemotherapy drugs both on malignancy sites and on healthy tissues, including the cells of male gonads.

Aim. To study the impact of drugs intended for the treatment of hemoblastoses on the total sperm count, their mobility, and the presence of pathological forms under experimental conditions.

Materials and methods. A case-control study was conducted on 18 male rats aged 90 days. The control group consisted of male rats that did not receive hemoblastosis treatment drugs, and the second group was intraperitoneally injected with cyclophosphamide, hydroxydaunorubicin, vincristine, prednisolone (hereinafter referred to as CHOP). Mature spermatozoa were obtained from the dissected appendages of the testes, by opening them on a thermal stage. The contents of the rat's seminiferous tubules, in a volume of 0.02 ml, were diluted in 0.4 ml of 0.9% sodium chloride solution, preheated to 37°C. The total, absolute, and relative number of spermatozoa in a unit volume (0.4 ml) of epididymal suspension was counted, taking into account their mobility according to the generally accepted system. Actively mobile and weakly mobile were attributed to the fertile fraction, and "twitching" and immobile - to the infertile fraction of epididymal spermatozoa. Then, the fertility index was calculated, which represents the ratio of the number of fertile forms to infertile ones. To determine the viability of spermatozoa, their count with regard to mobility was conducted within the first hour every 15 minutes, and subsequently every 30 minutes until the complete cessation of all spermatozoa. To assess the pathological forms of spermatozoa, the absolute and percentage content of spermatozoa in a unit volume (0.4 ml) of epididymal suspension with defects in the head, neck, midpiece, and tail was counted under light microscopy.

Results. The experimental exposure to CHOP group drugs had the following effects: a decrease in the total number of spermatozoa by 37% was observed in the male rats of the experimental group, accompanied by an increase in the number of their pathological forms by 26% compared to the control group.

Conclusion. The increased risk of infertility, caused by the toxic effect of drugs intended for the treatment of hemoblastoses, is associated with a decrease in the total number of spermatozoa and an increase in pathological forms, leading to a reduction in the number of mobile cells.

Introduction. To clarify the role of oxidative stress in the development of cataracts, it is necessary to determine the content of oxidative modification products directly in the eye tissue, but such studies are scarce, which is due to the difficulty of obtaining a sufficient amount of biomaterial for analysis and the need to use highly sensitive research methods as a result. Therefore, to assess the pathological changes in the lens, intraocular or tear fluid is used.

Aim. To elucidate the role of oxidative stress in the development of cataracts by determining the content of lipid oxidation products and their comparative characteristics in intraocular fluid and in blood plasma in patients with cataracts associated with chronic non-infectious diseases.

Materials and methods. The study involved 83 patients with cataracts associated with non-infectious diseases, who underwent surgical treatment. Of these, 30 patients had chronic obstructive pulmonary disease (COPD) as a comorbid condition, 45 had cardiovascular diseases (CVD), and 13 had diabetes mellitus (DM). The control group consisted of 30 practically healthy individuals without clinical signs of acute or chronic diseases. Lipid oxidation products were determined by ultraviolet spectroscopy. Absorption spectra of non-oxidized lipids (E204), diene conjugates (E233), conjugated trienes, and ketodiene (E278) were recorded. Additionally, the ratios of absorption spectra of diene conjugates to non-oxidized lipids (E233/E204), as well as conjugated dienes and ketodienes to non-oxidized lipids (E278/E204), were calculated. Tear and intraocular fluids, as well as blood plasma, served as materials for the study.

Results. In the group of patients with cataracts associated with non-infectious diseases, the content of diene conjugates, conjugated trienes, and ketodienes was increased relative to similar indicators in the tear fluid of people in the control group. Moreover, more pronounced changes were observed in the group of patients with cataracts associated with COPD relative to those with CVD and DM. A comparative analysis confirmed that in the group of patients with cataracts associated with COPD, the content of oxidized lipids in intraocular fluid and in blood plasma was increased. Correlation-regression analysis showed a positive relationship between the indicators of diene conjugates in intraocular fluid and in blood plasma.

Conclusions. The significant direct linear relationship between the indicators of oxidized lipids in intraocular fluid and in blood plasma in patients with cataracts and non-infectious diseases may indicate the possibility of using blood plasma for studying oxidative processes in the lens and its pathological changes for the purpose of selecting therapy and evaluating treatment efficacy. The results obtained confirm the role of oxidative stress in the development of cataracts in patients with chronic non-infectious diseases.

Cystic fibrosis is an autosomal recessively inherited monogenic disease caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, located on the long arm of chromosome 7 (7q31.2). This mutation results in a disruption in the transport of sodium and chloride ions between intercellular fluid and the epithelial cells of the excretory ducts of the exocrine glands. This paper presents the description of a family case of cystic fibrosis involving two patients who have been under observation since birth and are sisters (patient A – 4 years 10 months, patient B – 1 year 11 months). In both patients, neonatal screening and sequential diagnosis of cystic fibrosis identified the DF508/CFTRdele2.3(21kb) mutation, the most prevalent among the Caucasian population in the Russian Federation. The primary concern in managing both patients is the correction of nutritional status and minimization of exacerbations of chronic bronchopulmonary inflammation. To determine the management strategy for these patients, a consultation was held with Dr. E.I. Kondratyeva, a leading cystic fibrosis expert and professor at the MGSC Institute, who serves as the head of the Scientific and Clinical Department of Cystic Fibrosis and the Department of Genetics of Respiratory System Diseases, an expert of the European Society for Cystic Fibrosis Committee on Diagnostics and Registry, and Deputy Chief for Scientific Work of Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region. The peculiarity of the presented clinical cases lies in the fact that within one family, with an interval of 3 years, two girls with severe disease were born. Early diagnosis was performed for both, which has allowed for the slowing down of the pathology's progression.

Introduction. Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently co-occur in clinical practice, presenting challenges in differential diagnosis due to shared risk factors, an adverse comorbid landscape, and nonspecific symptoms. The coexistence of COPD and CHF significantly affects the prognosis for both conditions because of their mutual exacerbation. Evaluating the heart's structural and functional status in COPD patients is essential for early identification of cardiovascular complications, thereby improving prognosis and reducing mortality.

Aim. To review the latest global literature on diagnosing heart failure in COPD patients. Materials and methods. This review compiles data from literature sources, primarily from the last five years, sourced from PubMed and eLibrary, incorporating older publications as necessary.

Results. The review discusses current laboratory diagnostics and medical imaging techniques for identifying heart failure, crucial for preventing severe complications. Primarily, transthoracic echocardiography stands out as the most accessible and cost-effective method, playing a pivotal role in diagnosing and monitoring heart failure today.

Conclusion. Heart failure is a subject of extensive publication with a detailed description of laboratory and instrumental methods, including the latest advances in magnetic resonance and computed tomography. Transthoracic echocardiography continues to be the "gold standard" in both the diagnostic and prognostic assessment of heart failure-related changes.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, accounting for approximately 6% of all deaths, confirming its relevance and making it a subject of close attention of the global medical community. The integration of physical activity (PA) into the regimen of patients with COPD plays a key role in maintaining their health and improving quality of life. However, despite the inclusion of PA in pulmonary rehabilitation programs having become a routine method, questions remain today about establishing several universal formats of rehabilitation measures on the one hand and personalization on the other. This review is based on the analysis of relevant publications obtained as a result of selective literature search using the following keywords: COPD, quality of life, physical activity, pulmonary rehabilitation. Articles indicating the effects of PA as one of the main components of comprehensive pulmonary rehabilitation in patients with COPD are considered. Tools for assessing PA, its impact on the frequency of disease exacerbations, and mortality are discussed. Results confirming the importance and necessity of physical exercises as part of pulmonary rehabilitation are presented, as well as modern problems faced by specialists conducting pulmonary rehabilitation and their potential solutions.